Journal Watch

  • Heart Disease? PD is a Good Option

    In a single clinic study, 112 new patients starting PD with or without heart disease were followed for 5 years. More people with heart disease had diabetes (53.3% vs. 31.7%), and they tended to be older. But, there were no differences between groups in hospital admissions, peritonitis, or PD technique failure.

    Read the abstract » | (added 2017-02-08)

  • More Hospital Readmissions with PD Than In-Center HD

    Those on PD have fewer routine clinic visits than those on standard in-center HD. This may help explain why a 10-year study of hospital discharges among 28,026 dialyzors in Canada found that 30-day readmission rates in PD patients were higher (7.1) than for matched patients doing standard in-center HD (6.0). Better care transitions may help.

    Read the abstract » | (added 2017-02-08)

  • Medicare Payment for Daily Home HD Varies Geographically

    According to Medicare claims data for in-center HD and home HD from 2009-2012, there were persistent variations in the home HD treatment claims paid by different Medicare contractors. Fortunately, these differences did not seem to affect whether clinics offered home HD.

    Read the abstract » | (added 2017-02-08)

  • A New Approach for Treating Peritonitis in Patients Over Age 50

    Researchers tried a new, 3-step “Mero-PerRest” protocol when patients over age 50 developed peritonitis due to enteric (gut) microorganisms. 1). Temporary “peritoneal rest” with the catheter in place. 2). IV meropenem. 3). Meropenum as a catheter lock. Compared to 203 bouts of peritonitis treated with usual care, 217 bouts treated with the new protocol had a higher primary cure rate (90% vs. 65.3%), better PD survival (90% vs. 64.9%), and similar patient survival.

    Read the abstract » | (added 2017-02-08)

  • Autonomy is Key to Choice of PD

    French researchers interviewed 150 patients who began dialysis between 2010 and 2014 from four clinics, and their nephrologists, to see what factors influence the choice of PD. Of those who could do PD or HD, 46.7% preferred PD. The main reason for this preference was having or wanting to have autonomy.

    Read the abstract » | (added 2017-02-08)

  • Low Molecular Weight Heparin Use in Nocturnal HD

    Since people sleep during nocturnal HD, a form of heparin with a longer half-life is needed to keep blood from clotting. Enter low molecular weight heparin (LMWH). A study in Hong Kong* randomized 12 nocturnal HD patients to receive nadroparin or unfractioned heparin for a week—and then switch. The researchers concluded that LMWH was safe and effective, though if treatments are done each night, it is important to monitor for build up of the heparin in the blood.

    Read the abstract » | (added 2017-01-09)

  • Early and Late Outcomes in Urgent-start PD

    A single-center, matched-case control study compared 26 urgent start PD patients to 78 who started PD in the standard fashion. Urgent-start PD was linked with more catheter leaks and catheter migration. But, the rates of infection were similar, and urgent-start PD was safe.

    Read the abstract » | (added 2017-01-09)

  • Peritonitis Predicts Long-term Cardiac Outcomes on PD

    A large study (n=5,707) of PD patients from Brazil has found that just one bout of peritonitis boosts the risk of late cardiovascular death by 22%. Two bouts of peritonitis raised the risk by 78%, three by 181%, and four by 284%.

    Read the abstract » | (added 2017-01-09)

  • Using PET Results to Screen for Encapsulating Peritoneal Sclerosis (EPS)

    Identifying EPS early is vital to effectively treat this rare but devastating problem. Researchers studied whether the amount of sodium removed from the dialysate (sodium sieving) could predict EPS, in a 20-year study of 161 people. Age at PD start, duration of PD, and sodium sieving were all important predictors.

    Read the abstract » | (added 2017-01-09)

  • PD Patient Education in Australia

    Clinical PD outcomes in Australia were as much as 10-fold different from one site to another. An effort to standardize PD teaching has begun to improve PD outcomes. Of the 54 PD clinics, 70% completed an online survey about their PD teaching practices—which varied widely in the number of hours and presence of competency assessments.

    Read the abstract » | (added 2017-01-09)